INVESTIGADORES
MANES Facundo Francisco
congresos y reuniones científicas
Título:
Neural basis of decision making and reward: Disentangling euthymic patients with Bipolar disorder from adults with ADHD
Autor/es:
AGUSTÍN IBÁÑEZ; AGUSTÍN PETRONI; HUGO URQUINA; MARCELO CETKOVICH; TERESA TORRALVA; FERNANDO TORRENTE; ESTEBAN HURTADO; RAPHAEL GUEX; SANDRA BAEZ; SERGIO STREJILEVICH; MARIANO SIGMAN; ALICIA LISCHINSKY; FACUNDO MANES
Lugar:
Berlín
Reunión:
Congreso; 3rd International Congress on ADHD From Childhood to adult disease; 2011
Institución organizadora:
World Federation ADHD
Resumen:
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Objective
Attention deficit and hyperactivity deficit disorder (ADHD) in adults, as well
as the bipolar disorder (BD) share several DSM-IV criteria and present high
rates of comorbidity.Both disorders present problems in everyday decision
making. Nevertheless, previous decision making studies has shown inconsistent
results. The goal of this work is to assess decision making with different
tasks (behavioral as well neural correlates) of decision making in adult ADHD,
BD a group of controls.Method
13 ADHD patients, 13 BD patients and 25 controls (matched for age, sex and
years of education), were assessed.We considered the Iowa gambling task (IGT),
a modified version of a simple task of rational decision making under risk
(RDMUR, Fernandez-Duque & Wifall, 2007; Judgment and Decision Making), and
a rapid-decision gambling task (RDGT) witch elicit neurophysiological process
(ERPs) involved in rapidly evaluation of motivational impact of events and in
guiding choice behavior (Gehring, et al., 2002, Science). In order to assess
the relation of decision making tasks and individual differences we include a
multivariate analysis between ERPs and the groups neurocognitive profile.Results
No relevant differences on decision making assessed with neuropsychology (IGT
and RDMUR) were observed between groups. Compared to controls, only last blocks
of IGT (4 and 5) in BD group showed a tendency to select risky cards.
Nevertheless, the RDGT assess with ERPs shown significant differences. Feedback
error related negativity (fERN) distinguished between monetary win and losses
in control group. In ADHD and BD, fERN did not discriminate between win and
loss. Consistently with those result, analysis of source location (Brainstorm)
evidenced reduced responses of anterior cingulated cortex (ACC) to monetary
reward/punishment in ADHD and BD. Moreover, late neural processing related to reward
magnitude (P3) was impaired in both, ADHD and BD. Important differences were
observed between those disorders regarding neuropsychological profile and
multivariate association to decision making results. ADHD showed a pattern of
impaired reversal learning and non-flexible responses to negative feedback.
Those impairments were associated to clinical profile of impulsivity and
hyperactivity. BD showed an abnormal sensitivity to feedback and an enhanced
neural response to the magnitude of the reward (irrespective of the outcome
-win or loss-). Those patterns were associated to memory performance and to
psychopathological measures of depression and anxiety.Conclusion
Our data suggest that neurophysiological paradigms are well suitable for
assessing objective measures of those everyday impairments of decision making
in ADHD and BD. Finally, our results in ADHD and BD are discussed in the
framework of models of reward processing and ACC.
